21 Sep Patient Experience: Timliness

Last night I gave my father a call to check in and see how he is doing. My dad is in really good health, retired, and about to turn 69 this year. I typically speak to him once a week, and usually see him about the same. However this week due to work, managing global calls, it slipped and didn’t get my chance to check in.
When he answered the phone I immediately knew something was a bit off. As always he asked me about my week, work, and I finally interrupted and asked, Dad, what is going on with you?
He informed me that he had gone to the urologist again due to a nagging prostatitis issue. They changed his medication. Then my father told me the real news, he has lost 13 lbs in nearly a week.
Immediately my heart fell into the pit of my stomach. I asked what the physician advised. Apparently the urologist thinks he has an infection, and also scheduled a follow up appointment to have an ultrasound performed this coming Friday.
In addition, my father hasn’t been able to sleep for more than 2 hours at a time, without having to get up to urinate. He hasn’t really had an appetite. When he does eat, the food is repulsive to him. His PSA is only 1.4 Vitals are all within normal ranges.
I called and spoke to my mother later in the evening to get additional information. My mother is a nurse. She suspects that it may be a symptom of depression. I disagree since he would have to be severely depressed, and I don’t see my father making the conscious decision to choose not to eat.
I fear that it could be worse, such as liver, pancreatic, or adrenal cancer. My mind races there due to my background, and I know his mother died of liver cancer and an unknown primary. I doubt it is Crohn’s or Celiac, due to his age and sudden manifestation.
Then I asked why they urologist is waiting until Friday to have an ultrasound performed. My other said it was the soonest they could get an appointment. I rebutted and said that is unacceptable. My mothers response is that it was the soonest appointment they could get, and there is nothing else they can do. They will just have to sit and wait.
My mother. A long time nurse, administrator, patient advocate. She accepts that the healthcare team, taking care of her loved one, her partner of 40 years, that she worries and has anxiety over this occurrence, she accepts the week long wait.
I don’t. (granted I know the urologist, I worked with him, I used to manage part of the hospital too, so I know how they work)
I told my mother I will call and they will get him in sooner. They work for her, for my father, for us. It is unacceptable for him to wait. To sit with anxiety, perhaps his condition remains stable or maybe improves, but it could worsen. To wait. The healthcare team and system work for them. for our family. They get paid to perform a service. Part of that service is to give me quality, accessible, and affordable care. Part of it is to get me the care on a timely basis.
The care is not to be for the convenience of the urologist, his staff, or his office. It’s not to accommodate the radiologist and their staff. It is to accommodate my father, meet his needs, and get him the right diagnosis and information, at the right time, to get him started on the right regimen.
It is great that everyone talks about the ‘patient experience.’ We can applaud ourselves for making it part of the water cooler discussions. The real applause will come when it is felt by the patient and families.
The metric shouldn’t be that it is being discussed. It should not be that it is part of some reimbursement impact that we report out to the government. The metric should be the speed at which we care for patients. In the end, without patients none of us have a job. So why not focus on why we are all in healthcare. Patients. Patients first, patients second, patients last. It is all about the patients.
Always.